| Sobha Panicker-thomas, | |
| 
					475 Seaview Ave, Staten Island University Hospital, Staten Island, NY 10305-3436  | |
| (718) 226-9000 | |
| Not Available | 
| Full Name | Sobha Panicker-thomas | 
|---|---|
| Gender | Female | 
| Speciality | Nurse Practitioner - Adult Health | 
| Location | 475 Seaview Ave, Staten Island, New York | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1134678022 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363LA2200X | Nurse Practitioner - Adult Health | F307945 (New York) | Primary | 
| Entity Name | Sv Operating Three Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1396003182 PECOS PAC ID: 2365601093 Enrollment ID: O20130122000209  | 
| Entity Name | Medical Director Services Pc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1871955807 PECOS PAC ID: 0042501116 Enrollment ID: O20160621000218  | 
| Entity Name | Patient First Medical Practice Pc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1255067955 PECOS PAC ID: 0042687006 Enrollment ID: O20221103001230  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Sobha Panicker-thomas, 475 Seaview Avenue, Staten Island University Hospital, Staten Island, NY 10305 Ph: (718) 226-9000  | Sobha Panicker-thomas, 475 Seaview Ave, Staten Island University Hospital, Staten Island, NY 10305-3436 Ph: (718) 226-9000  | 
Miss Margery Ann Shane, N.P. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2627 Hylan Boulevard, Suite C, Staten Island, NY 10306 Phone: 718-351-1136 Fax: 718-667-9711  | |
Genevieve Spota,  Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 130 Rose Ave, Staten Island, NY 10306 Phone: 718-980-1553  | |
Daniella Otaiza, F.N.P Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 5 Little Clove Rd, Staten Island, NY 10301 Phone: 718-876-9600 Fax: 718-876-7773  | |
Kristen Colandrea, PMHNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 475 Seaview Ave, Staten Island, NY 10305 Phone: 347-681-4146  | |
Alexis Rigo,  Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 475 Seaview Ave, Staten Island, NY 10305 Phone: 718-226-9000  | |
Alexandra Frances Manetta,  Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 73 Downes Ave, Staten Island, NY 10312 Phone: 718-517-0654  | |
Mrs. Amelia Tirado, N.P. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 139 Roe St, Staten Island, NY 10310 Phone: 718-720-6650  |